Clinical analysis of post-stroke epilepsy in children / 中华实用儿科临床杂志

ABSTRACT

Objective To analyze the clinical features,treatment and prognosis of children with post-stroke epilepsy.Methods Sixty-nine children with epilepsy after cerebral stroke who were admitted to Guangdong General Hospital from Jan.2009 to Mar.2013 were retrospectively reviewed,including etiology,clinical features,laboratory examinations,treatment and prognosis.Results Among 260 stroke patients,69 of them (26.5 ％) developed epilepsy,but there was no significant difference between boys and girls(x2 =0.725,P =0.394).The incidence of post-stroke epilepsy differed significantly among different types (x2 =12.000,P =0.02),highest in the children with subarachnoid hemorrhage(47.8％,11/23 cases),followed by those with cerebral hemorrhage (34.6％,27/78 cases),and lastly,those with cerebral ischemia (19.5％,31/159 cases).Among them,53 patients developed seizures in the early stage (76.8％,53/69 cases),others in the late stage(23.2％,16/69 cases),early-onset epilepsy was more common in hemorrhagic stroke and late-onset epilepsy was more common in ischemic stroke,which differed significantly(x2 ＝ 4.778,P =0.029).The electroencephalogram background generally showed slow-wave in the early-onset epilepsy.The composition of seizure types differed significantly among different types of stroke (x2 =8.461,P =0.015).Forty-five of 58 patients (77.6％) suffered from cortical lesions and 13 of 58 patients (22.4％) suffered from subcortical lesions.Those children with post-stroke epilepsy who regularly use of antiepileptic drugs were followed up for 6 months to 4 years,81.2％ (56/69 cases)of clinical seizures were controlled.Conclusions The incidence of epilepsy after stroke is higher in children than in adults,cerebral stroke seizure occurs more commonly in cases with hemorrhagic stroke,especially with subarachnoid hemorrhage.Conventional antiepileptic treatment is effective.